RSS Feedhttp://10.40.239.128/blogs/rss-feed/Blog RSS Feeden{D52BDF54-2F33-4394-AD28-D0865A8C1FAB}http://10.40.239.128/blogs/2014/12/new-technology-for-removing-breast-cancer/New Technology For Removing Breast Cancer<p>It&rsquo;s known as radioactive seed localization (RSL), and involves placing a tracker&mdash;a small and safe radioactive seed the size of a mustard seed&mdash;inside the breast tissue using ultrasound or mammography tools. In surgery, a gamma probe &ndash; a tool that senses radioactive material &ndash; is then used to scan over the patient&rsquo;s breast and find the exact spot of the abnormal tissue. We can then take out the bad tissue and the seed and send the patient home the same day. </p>
<p>The seed helps us find spots that can&rsquo;t be seen or felt. It may be cancer, a cluster of calcium or a benign lump, but the seed allows us to pinpoint it exactly and save more healthy tissue because of its accuracy. RSL has become a widely accepted treatment option for biopsies and lumpectomies, and is another option to needle (wire) localization.&nbsp; </p>
<p>With the wire, a needle is inserted into the patient&rsquo;s breast and a small wire threaded through it. The tip of the needle is placed near the bad tissue, and the wire extends outside of the breast. Sometimes the space from the needle to the surface of the skin is pretty big. We follow the wire to the general area, make a best guess, and remove the tissue. &nbsp;Because it&rsquo;s not exact, the wire option often removes extra tissue. Other disadvantages are that the wire must be placed right before surgery, it can move, and it is often uncomfortable for the patient.</p>
<p>In comparison, RSL provides several advantages to the patient, including </p>
<ul>
<li><strong>Increased Accuracy</strong><br />
<p>It is less likely that extra tissue will be taken out with RSL because the seed clearly marks the trouble spot. The tracker finds the location and allows us to get to the area from any angle, based on what will be the easiest and cosmetically best, and provides direction throughout the procedure. Since we must open up the tissue during surgery to remove the seed, we can look at the tissue on site and know whether or not all of the abnormal tissue has been removed. If not, we can go back and take a little more tissue, saving extra surgery, cost, worry, risk of infection and the look of the breast. </p></li>
<li><strong>Convenience</strong><br />
<p>The amount of radiation in the seed is very small, making it safe for the patient and members of the healthcare team. The seed can be placed up to two days before surgery. But most are done right before surgery. Placing the seed in the patient&rsquo;s breast takes less than 15 minutes and is done by a radiologist, and the surgery to remove the tissue takes about 30 minutes. Both are outpatient procedures and patients can return to regular activity the next day.</p></li>
<li><strong>Similar Cost<br /></strong>
<p>There is no additional cost to RSL, compared to the wire, and it produces better results.</p></li>
</ul>Mon, 01 Dec 2014 00:00:00 -0700{AE152FC7-CC5F-46E5-8383-8D0B2722DF31}http://10.40.239.128/blogs/2014/11/what-is-exclusive-breastfeeding/What is Exclusive Breastfeeding?<p style="margin: 0in 0in 10pt;">It&rsquo;s all they need&hellip;&hellip;really! (1) </p>
<p style="margin: 0in 0in 10pt;">Exclusive breastfeeding is what it sounds like.&nbsp; &nbsp;From the moment your baby is born, &ldquo;you give your newborn only colostrum/breastmilk and no other liquids or solids&rdquo; (2) (formula, glucose water, infant cereal, or foods). </p>
<p style="margin: 0in 0in 10pt;">The baby&rsquo;s doctor may prescribe specific vitamins, minerals, or possibly even medication-does that interfere with my desire to exclusively breastfeed?&nbsp; The answer to that question is NO, unless you are mixing the prescribed medication with formula or glucose water etc.&nbsp; The solution is to use expressed breastmilk.&nbsp; </p>
<p style="margin: 0in 0in 10pt;">If I want to give expressed colostrum/breastmilk in a bottle instead of the baby suckling at the breast for whatever reason, or if circumstances that my baby needs donor human milk in the Newborn Intensive Care Unit, does that mean that I am not exclusively breastfeeding?&nbsp; There are many reasons why a mother may choose or need to feed her baby this way, but this still means that she is still only providing human milk.&nbsp; &ldquo;While breastfeeding is the goal for optimal health, it is recognized that human milk provided indirectly is still superior to alternatives&rdquo;. (2)&nbsp; </p>
<p style="margin: 0in 0in 10pt;">References: </p>
<p style="margin: 0in 0in 10pt;"><em>1. Handout from Kaiser Permanente:&nbsp; Got Colostrum</em></p>
<p style="margin: 0in 0in 10pt;"><em>2.&nbsp; USBC:&nbsp; Implementing The Joint Commission Perinatal Care Core Measure on Exclusive Breast Milk Feeding.</em></p>Fri, 28 Nov 2014 00:00:00 -0700{F1BB5122-26C4-4D7C-8FE0-8DCC4518F107}http://10.40.239.128/blogs/2014/11/early-signs-of-pregnancy-what-to-look-for/Early Signs of Pregnancy – What to look for<p style="margin: 0in 0in 10pt;">No one likes to wonder if they&rsquo;re pregnant.&nbsp; For thousands of years people have searched for definitive ways to confirm a suspected pregnancy as soon as possible.&nbsp; MentalFloss.com tells of many different methods used throughout history to do this, as far back as 1350 BCE in Ancient Egypt.&nbsp; While the effectiveness of the pregnancy tests listed <a href="http://mentalfloss.com/article/48655/9-historical-methods-detecting-pregnancy">here</a> may be arguable, thankfully civilization has learned a bit since then.</p>
<p style="margin: 0in 0in 10pt;">I&rsquo;ve created a video to clear up <a href="https://www.youtube.com/watch?v=hjf_no5JSLY&amp;list=UU8bmJhVtkIIP_9I1-F6R1Cg">signs of pregnancy questions</a> some of the questions on this matter. </p>
<iframe height="315" src="//www.youtube.com/embed/hjf_no5JSLY?list=UU8bmJhVtkIIP_9I1-F6R1Cg" frameborder="0" width="560"></iframe>
<p style="margin: 0in 0in 10pt;">&nbsp;</p>
<p style="margin: 0in 0in 10pt;">Most studies have shown that women start to feel the early signs of pregnancy somewhere between 5-8 weeks of pregnancy. About 60% of women in a particular study felt symptoms by 5-6 weeks, meaning 5-6 weeks from their last period. Almost all the women were feeling symptoms by 8 weeks. Some of the most common early signs of pregnancy are:</p>
<ul>
<li>Nausea (with or without vomiting)</li>
<li>Food aversions or food cravings</li>
<li>Extra fatigue, not having a period (obviously)</li>
<li>Breast enlargement or tenderness</li>
<li>Even mood changes and sometimes light-headedness. </li>
</ul>
<p style="margin: 0in 0in 10pt;">Other symptoms can be present, but these are the most common symptoms. If you are pregnant and start to have any vaginal bleeding, be sure to talk to your OB provider and they can check you out and decide what's causing it and tell you more about what's going on.&nbsp;&nbsp;</p>
<p style="margin: 0in 0in 10pt;">Still unsure, you can check with many <a href="http://intermountainhealthcare.org/blogs/2014/04/free-pregnancy-testing">Intermountain Healthcare clinics</a> around Utah for a pregnancy test and conversation with a clinician. </p>
<p style="margin: 0in 0in 10pt;">If you have any questions for me, please feel free to ask them on our Facebook page, <a href="https://www.facebook.com/intermountainmoms">Intermountain Moms</a>, and don&rsquo;t forget to let your friends and family know about us too!</p>Fri, 28 Nov 2014 00:00:00 -0700{4488AB24-D37F-4F49-8405-6071D7AF9149}http://10.40.239.128/blogs/2014/11/planning-for-a-shared-accountability-health-plan-product/Planning for a “Shared Accountability” health plan product<p>In 2011, Intermountain Healthcare set a significant commitment to lower the projected increase in healthcare costs by 2016. We are currently on track to meet that objective &mdash; saving the community hundreds of millions of dollars. At the same time, we continue to improve clinical outcomes and quality of care.</p>
<p>Intermountain and SelectHealth will launch a commercial health plan product in 2016 based on &ldquo;Shared Accountability&rdquo; principles. That means that everyone involved&mdash;hospitals, physicians, patients, and employers&mdash;will share accountability in choices that affect participants&rsquo; health and healthcare choices. Intermountain and SelectHealth will keep average annual premium rate increases on this product close to the general inflation rate. That will be a significant cost savings for all involved. </p>
<p><b>More details about the &ldquo;Shared Accountability&rdquo; health plan product: </b></p>
<p><b>The official name of the product is still to be determined.</b> We&rsquo;re tentatively referring to it as the &ldquo;Shared Accountability&rdquo; product, because the plan is based on Shared Accountability concepts.</p>
<p><b>SelectHealth has expertise with other similar plans. </b>Currently, SelectHealth offers two fee-for-value plans based on accountable care principles: SelectHealth Advantage (a Medicare Advantage plan) and SelectHealth Community Care (a Utah Medicaid Accountable Care plan). SelectHealth will be the first payer to offer Intermountain&rsquo;s Shared Accountability approach to the commercial market, offering it to fully insured large employers that are purchasing health plans for their employees.</p>
<p><b>The Shared Accountability product will be informed by a Physician Payment Model beta test.</b> Intermountain launched the test in the fall of 2013. The beta includes a small number of patients served by 383 physicians at 15 clinics. Both primary care and specialist physicians are participating. Tools developed for the model give physicians access to information that supports care decisions. Clinicians can see current performance and feedback on service, quality, and total-cost-of-care goals. They can also see overall health measures for the group of patients, patient risk scores, and variances in how care is provided. With input from participating physicians, we continue to evaluate and refine these tools as we consider expanding their use.</p>
<p><b>SelectHealth is designing benefits to engage plan members &mdash; and support physicians. </b>The plan benefit design will encourage and reward members for being more engaged in their personal health and wellness and more involved in their personal healthcare decisions.</p>
<p><b>This model is significantly different from traditional fee-for-service models that pay based on volumes of covered services provided.</b> We anticipate other payers will be developing similar products. In fact, according to a report at a recent Leavitt Partners conference, more than 600 &ldquo;fee-for-value&rdquo; networks are already being developed nationwide.</p>Fri, 28 Nov 2014 00:00:00 -0700{5DCF41B3-B572-4932-99C6-0B2954023FA4}http://10.40.239.128/blogs/2014/11/taking-control-of-blood-sugars-at-school/Taking Control of Blood Sugars at School<p style="margin: 0in 0in 8pt;"><span style="text-decoration: underline;">Taking Control of Blood Sugars at School</span> </p>
<p style="margin: 0in 0in 8pt;">Parents of children with Type 1 and Type 2 Diabetes, as well as high school and college students with Type 1 and Type 2 Diabetes, often struggle with control of their Blood Sugars during class-time.&nbsp;&nbsp; Test taking, field trips, unexpected high intensity exercise and holiday treats are just a few of the daily dilemmas that students face.</p>
<p style="margin: 0in 0in 8pt;">Here are a few tips that can help children/adolescents with Type 1 Diabetes be successful with diabetes control at school:</p>
<p style="margin: 0in 0in 8pt;"><b>S</b><b>&nbsp;&nbsp;-&nbsp; </b><b>START OUT RIGHT</b></p>
<ul>
<li>Contact your school nurse or district nurse.
<ul>
<li>Nurse phone numbers are available on the school district&rsquo;s websites.</li>
<li>Nurses are available 1-2 weeks before school starts.</li>
</ul>
</li>
<li>Assume the positive &ndash; the school principal, counselors, teachers, secretaries also want your child to be successful at school.&nbsp; They are your support team.</li>
<li>Verify which school personnel are available to help your children and who will be trained to give glucagon.</li>
</ul>
<p style="margin: 0in 0in 8pt;"><b>C</b>&nbsp;<strong>-&nbsp;</strong>&nbsp;<b>COMPLETE the FORMS</b></p>
<ul>
<li>Start early and make time to contact the diabetes clinic at 801.213.3599 or by email at <a href="mailto:pcmcbglogs@imail.org">pcmcbglogs@imail.org</a> to request your child&rsquo;s Diabetes Medical Management Plan.&nbsp; Contact the clinic 3-4 weeks prior to the start of school each year and relay the schools name, schools fax number and your child&rsquo;s current insulin doses.&nbsp; </li>
</ul>
<p style="margin: 0in 0in 8pt;"><b>H</b>&nbsp;&nbsp;<strong>-&nbsp;&nbsp; HELPFUL HINTS about your CHILD</strong></p>
<ul>
<li>Provide the school with information that is unique to your child.
<ul>
<li>Eating habits &ndash; likes and dislikes, food preferences (especially those used for treating lows).</li>
<li>Information on recognizing and treating signs and symptoms of low or high blood glucose levels</li>
<li>Special needs.</li>
</ul>
</li>
</ul>
<p style="margin: 0in 0in 8pt;"><b>O</b>&nbsp;&nbsp;<strong>-</strong>&nbsp; <b>OPTIMIZE CONTROL</b> </p>
<ul>
<li>Blood glucose monitoring and carbohydrate counting can be done at school.&nbsp; School lunch information is available from the school district website and the lunch manager of your school.&nbsp; Work with your district/school nurse to outline when testing is to be done and to designate school personnel who will be providing supervision.&nbsp; </li>
<li>Remember, getting insulin on board at least ten minutes before a meal helps it work best.&nbsp; </li>
</ul>
<p style="margin: 0in 0in 8pt;"><b>O</b>&nbsp;&nbsp;<strong>-</strong> <b>OPEN UP!&nbsp; COMMUNICATE!</b></p>
<ul>
<li>
<div style="margin: 0in 0in 8pt;">You know your child the best!&nbsp; The information you have about your child&rsquo;s diabetes is the most important tool you can provide for the school.&nbsp; Be your child&rsquo;s advocate.</div>
</li>
<li>Provide the school with current information and tools.</li>
</ul>
<p style="margin: 0in 0in 8pt;"><b>L</b>&nbsp;&nbsp;<strong>&nbsp;-&nbsp;</strong>&nbsp; <b>LEARN TO BE PREPARED</b></p>
<ul>
<li>Provide the appropriate supplies that your child needs to manage his/her diabetes at school:&nbsp; </li>
</ul>
<p>Food items to treat low blood glucose: </p>
<ul>
<li>Glucagon Emergency kit </li>
<li>Insulin</li>
<li>Blood glucose test strips</li>
<li>Insulin pens and pen needles or vial and syringes</li>
<li>Backup supplies for insulin pump</li>
</ul>
<p style="margin: 0in 0in 8pt;"><em>(taken from handout: PCH Diabetes Clinic:&nbsp; &ldquo;Getting Ready to go back to School&rdquo;)</em></p>
<p style="margin: 0in 0in 8pt;">School personnel, teachers and professors play an important integral role in the diabetes care and control of blood sugars for their students that have Type 1 Diabetes.&nbsp; The American Diabetes Association has developed a guide for school personnel as well as many other resources for parents and for students with diabetes.&nbsp; Please see their website at <a href="http://www.diabetes.org/"><strong>www.diabetes.org</strong></a> &ndash; Living with diabetes/parents and kids/diabetes care at school.</p>
<p style="margin: 0in 0in 8pt;">There are many students with diabetes who are able to maintain optimal blood sugar control while at school.&nbsp; Success comes from planning, communication, and continued support.</p>Wed, 26 Nov 2014 00:00:00 -0700{F4F880C6-4535-4ECA-A4D9-489AD177E08C}http://10.40.239.128/blogs/2014/11/nursing-researchers-gather-for-2014-conference/Nursing Researchers Gather for 2014 ConferenceHundreds of nursing researchers filled the ballroom at Weber State University on October 24 for the 9th Annual Nursing Research Conference, titled "Advancing Nursing Through Research, Education, and Practice."<br />
<br />
<p>
This year&rsquo;s conference provided an opportunity to learn about current nursing research that influences both nursing education and practice. In addition to learning from internationally recognized nurse scholars and researchers, a poster session provided a venue for the dissemination of current, regional projects related to nursing research, educational innovations, and evidence-based practice.</p>
<br />
Speakers included:&nbsp;<br />
<br />
JUDITH BERG, Ph.D, RN, WHNP-BC, FAAN, FAANP<br />
President of Western Institute of Nursing<br />
Clinical Professor<br />
<br />
SUE HENLY, Ph.D, RN<br />
Editor, Nursing Research<br />
Professor, University of Minnesota School of Nursing<br />
<br />
JAN MORSE, Ph.D, RN<br />
Barnes Endowed Chair, University of Utah College of Nursing<br />
<br />
BARBARA WILSON, Ph.D, RN<br />
Associate Dean of Academic Programs<br />
University of Utah College of Nursing<br />
<br />
<p>
The poster session included about 30 posters. It was great to see our new Intermountain Healthcare Research poster template in use, bringing a high-quality, consistent professional look to our presentations!</p>
<br />
<em>
Intermountain Healthcare was among the sponsors of this conference.</em>Mon, 24 Nov 2014 00:00:00 -0700{C7859725-06B4-4ACE-8CD1-00663919CF10}http://10.40.239.128/blogs/2014/11/improved-handoff-communication-reduces-medical-error-injuries-by-30-percent/Improved Handoff Communication Reduces Medical Error Injuries by 30%<p>A multicenter study led by researchers from Boston Children&rsquo;s Hospital shows that the I-PASS bundle<strong> </strong>improves patient safety and quality of care. Physicians at Primary Children&rsquo;s Hospital and the University of Utah School of Medicine participated as one of the nine pediatric hospitals in the I-PASS study. </p>
<p>Reported Nov. 6 in the <em>New England Journal of Medicine </em>(<em>NEJM</em>), the study results show that I-PASS&mdash;an original system of bundled communication and training tools for handoff of patient care between providers&mdash;can greatly increase patient safety without significantly burdening existing clinical workflows.</p>
<p>An estimated 80 percent of the most serious medical errors can be linked to communication deficiencies among clinicians, particularly during patient handoffs. To address these problems, the I-PASS bundle consists of:</p>
<ul>
<li>standardized communication and handoff training</li>
<li>a verbal handoff process organized around the verbal mnemonic "I-PASS" (<strong>I</strong>llness severity, <strong>P</strong>atient summary, <strong>A</strong>ction list, <strong>S</strong>ituational awareness and contingency planning, and <strong>S</strong>ynthesis by receiver)</li>
<li>computerized handoff tools to share patient information between providers using an I-PASS structure</li>
<li>engagement of supervising attending physicians to observe and oversee handoff communications</li>
<li>a campaign promoting the adoption of I-PASS as part of institutional process and culture </li>
</ul>
<p>James Bale, M.D., Raj Srivastava, M.D., M.P.H., and Adam Stevenson, M.D. co-led the Primary Children&rsquo;s Hospital/University of Utah School of Medicine team. Leadership within Intermountain&rsquo;s <strong>Institute for Health Care Delivery and Research </strong>had additional responsibilities by taking a lead role in the overall governance and conduct of the study.</p>
<p>The researchers monitored patient handoffs by residents at each participating hospital, and assessed them for a six-month pre-intervention period. During the six-month intervention phase, residents were trained on I-PASS handoff processes and required to use the system going forward. An additional six months of monitoring and assessment followed the intervention. </p>
<p>Across the participating centers, the overall rate of medical errors decreased by 23 percent&mdash;from 24.5 to 18.8 errors per 100 admissions&mdash;after the introduction of I-PASS. Preventable adverse events (injuries due to medical errors) decreased by 30 percent&mdash;from 4.7 to 3.3 errors per 100 admissions. The research team's data covered a total of 10,740 patient admissions.</p>
<p>Time-motion analyses of providers' activities showed that implementing I-PASS did not add time to patient handoffs or decrease time spent at patient bedsides or on other tasks. The researchers noted significant improvements in residents' verbal and written communications at every center and a significant increase in residents' satisfaction with the quality of their patient handoffs after I-PASS implementation, according to a post-study survey. </p>
<p>Additionally, the I-PASS system <a href="http://betaboston.com/news/2014/11/20/boston-health-tech-groups-are-finalists-in-harvards-health-acceleration-challenge/">has been named a finalist</a> in the Harvard Health Acceleration Challenge.</p>
<p>Find the I-PASS curriculum online at <a href="http://www.ipasshandoffstudy.com/">ipasshandoffstudy.com</a>. For consultation and ongoing support with program implementation for institutions, email <a href="mailto:ipass.study@childrens.harvard.edu">ipass.study@childrens.harvard.edu</a>.</p>
<p><em></em></p>Fri, 21 Nov 2014 00:00:00 -0700{A6EF918C-50B3-4B95-9BBF-2EF455D091CB}http://10.40.239.128/blogs/2014/11/get-smart-about-antibiotics-day-5/Get Smart About Antibiotics Day 5: Prevent Infections<p style="margin: 0in 0in 8pt;">Many infections that used to be common in our country and around the world can be prevented by vaccination.</p>
<p style="margin: 0in 0in 8pt;">Vaccinations help prepare our bodies to fight the microbes before we get diseases.</p>
<p style="margin: 0in 0in 8pt;">Vaccines save lives and avoid illness.</p>
<p style="margin: 0in 0in 8pt;">Get smart about antibiotics. Make sure you and yours are up to date with <a href="http://www.cdc.gov/vaccines/"><strong>vaccinations</strong></a>!</p>Fri, 21 Nov 2014 00:00:00 -0700{5179A54F-4E52-4FCA-B52B-4CD727F6EE12}http://10.40.239.128/blogs/2014/11/holiday-seasons-eating-with-diabetes/Holiday Seasons Eating with Diabetes<p>During this holiday season make a promise to put yourself at the top of your list. As hard as you've worked to stay on course with managing your diabetes throughout the year, the holiday season has the potential to throw you off. Travel, parties, big meals, snack foods at the office and drinking all create a challenging environment for eating healthy. Add to that the days of travel with little scheduled exercise, and it becomes a real effort to stay on track.</p>
<ul>
<li>Eat breakfast or healthy snacks early in the day and avoid the idea of saving carbs for the big feast later on.</li>
<li>Limit the number of servings of starchy foods on your plate, such as mashed potatoes, sweet potato casserole and rolls or just take a few spoonful or bites. Choose fresh fruits and vegetables; Fill &frac12; your plate with raw, grilled or steamed. &nbsp;Avoid the creams, gravies and butter.</li>
<li>Stick to calorie free drinks, such as water, tea, diet sodas instead of punch or mixed drinks.</li>
<li>If you choose to drink alcohol, limit the amount you have with food. Women limit to 1 alcohol drink per day, Men should drink no more than two.&nbsp; (12 oz beer, 5fl oz. of wine, 1 &frac12; fl. oz. of 80 proof spirits, 1 fl. oz. of 100 proof spirits.</li>
<li>Enjoy your favorite holiday treats, but take small portions, eat slowly and savor the taste. </li>
<li>After your meal, take a walk with family and friends. Focus on your goals, and give you a welcome break from being surrounded by treats.&nbsp; Exercise is a great way to lower your blood sugar. </li>
<li>If you overindulge, don&rsquo;t beat yourself up. If you eat more carbs or food than you planned for, don&rsquo;t think you have failed; just make a plan to get back on track the following day.</li>
</ul>
<p>&nbsp;</p>
<p style="margin: 0in 0in 10pt;">Adapted from Holiday Season Eating for people with Diabetes, by the American Association of Diabetes Educators. </p>Fri, 21 Nov 2014 00:00:00 -0700{84E50FEA-F6A9-42E8-9EF7-7F472B180A8A}http://10.40.239.128/blogs/2014/11/get-smart-about-antibiotics-day-4/Get Smart About Antibiotics Day 4<p style="margin: 0in 0in 8pt;">Antibiotics can be miracle drugs and remarkably safe. However, they are <a href="http://www.cdc.gov/MedicationSafety/program_focus_activities.html">not without risks</a>. In fact, antibiotics are responsible for almost 1 of 5 emergency room visits related to medication use. Annually, there are more than 140,000 emergency department visits for reactions to antibiotics.</p>
<p style="margin: 0in 0in 8pt;">Allergic reactions are responsible for about 80% of these reactions. Mild rashes to severe allergic reactions are reported with antibiotic use. Antibiotics may also cause diarrhea.</p>
<p style="margin: 0in 0in 8pt;">One way to reduce the number of reactions to antibiotics is to use them when we need them.</p>
<p style="margin: 0in 0in 8pt;">For example, there is a 1 in 1,000 chance a patient will require a visit to the emergency room for an antibiotic adverse event, there is a 1 in 4,000 chance an antibiotic will prevent a serious complication from an <a href="http://www.cdc.gov/getsmart/campaign-materials/treatment-guidelines.html">upper respiratory tract infection</a>.</p>
<p style="margin: 0in 0in 8pt;">What you can do:</p>
<ul>
<li>
<div style="margin: 0in 0in 8pt;">Don&rsquo;t take antibiotics when it is likely a viral infection</div>
</li>
<li>
<p style="margin: 0in 0in 8pt;">Take antibiotics exactly how your health care professional says</p>
</li>
<li>
<p style="margin: 0in 0in 8pt;">Don&rsquo;t take antibiotics, unless they are prescribed for you</p>
</li>
</ul>Thu, 20 Nov 2014 00:00:00 -0700